POS0273 POST COVID-19 SYNDROME IN PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES: RESULTS FROM THE COVAD STUDY
Authors: P. Sen, N. Ravichandran, M. Joshi, S. Saha, K. Jagtap, V. Agarwal, O. Distler, E. Nikiphorou, A. L. Tan, S. Katsuyuki Shinjo, N. Ziade, T. Velikova, M. Milchert, I. Parodis, A. E. Gracia-Ramos, L. Cavagna, M. Kuwana, J. Knitza, A. Makol, A. Patel, J. Pauling, C. Wincup, B. Barman, E. A. Zamora-Tehozol, J. Rojas-Serrano, I. Garcia-De La Torre, I. J. Colunga-Pedraza, J. Merayo-Chalico, W. Katchamart, P. A. Goo, Y. M. Chen, L. S. Hoff, L. Kibbi, H. Halabi, B. Vaidya, S. S. Shaharir, R. Shumnalieva, A. T. M. T. Hasan, D. Dzifa, C. E. Toro Gutierrez, C. Vinicio Caballero, J. B. Lilleker, B. Salim, T. A. Gheita, T. Chatterjee, A. Nune, M. A. Saavedra, J. Day, H. Chinoy, V. Agarwal, R. Aggarwal, L. Gupta
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Post COVID-19 syndrome (PCS) is an emerging cause of morbidity and poor quality of life in COVID-19 survivors [1, 2]. <h3>Objectives</h3> We aimed to assess the prevalence, risk factors, outcomes, and association with disease flares of PCS in patients with autoimmune rheumatic diseases (AIRDs) and non-rheumatic autoimmune diseases (nrAIDs), both vulnerable groups understudied in the current literature using data from the 2<sup>nd</sup> COVID-19 Vaccination in Autoimmune Diseases (COVAD) global multicentre patient self-reported e-survey. <h3>Methods</h3> The survey was circulated from February to July 2022 by the international COVAD Study Group (157 collaborators from 106 countries), and demographics, comorbidities, AIRD/nrAID status, COVID-19 history, vaccination details, and PROMIS physical and mental function were recorded. PCS was defined as symptom resolution time &gt;90 days following acute COVID-19. Predictors of PCS were analysed using regression models for the different groups. <h3>Results</h3> 7666 total respondents completed the survey. Of these, 2650 respondents with complete responses had positive COVID-19 infection, and 1677 (45.0% AIRDs, 12.5% nrAIDs, 42.5% HCs) completed the survey &gt;90 days post acute COVID-19. Of these, 136 (8.1%) had PCS. Prevalence of PCS was higher in AIRDs (10.8%) than healthy controls HCs (5.3%) (OR: 2.1; 95%CI: 1.4-3.1, p=0.002). Across the entire cohort, a higher risk of PCS was seen in women (OR: 2.9; 95%CI: 1.1-7.7, p=0.037), patients with long duration of AIRDs/nrAIDs (OR 1.01; 95%CI: 1.0-1.02, p=0.016), those with comorbidities (OR: 2.8; 95%CI: 1.4-5.7, p=0.005), and patients requiring oxygen supplementation for severe acute COVID-19 (OR: 3.8; 95%CI: 1.1-13.6, p=0.039). Among patients with AIRDs, comorbidities (OR 2.0; 95%CI: 1.08-3.6, p=0.026), and advanced treatment (OR: 1.9; 95%CI: 1.08-3.3, p=0.024), or intensive care (OR: 3.8; 95%CI: 1.01-14.4, p=0.047) for severe COVID-19 were risk factors for PCS. Notably, patients who developed PCS had poorer PROMIS global physical [15 (12-17) vs 12 (9-15)] and mental health [14 (11-16) vs 11 (8-14)] scores than those without PCS. <h3>Conclusion</h3> Individuals with AIRDs have a greater risk of PCS than HCs. Associated comorbid conditions, and advanced treatment or intensive care unit admission for severe COVID-19 confer a higher risk of PCS. It is imperative to identify risk factors for PCS for immediate multidisciplinary management in anticipation of poor physical and mental health. <h3>References</h3> [1]Pavli A, Theodoridou M, Maltezou HC. Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals. Archives of Medical Research, 2021; 52: 575-581. [2]Malik P, Patel K, Pinto C, Jaiswal R, Tirupathi R, Pillai S, et al. Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)—A systematic review and meta-analysis. Journal of Medical Virology, 2022; 94:253-262. <h3>Acknowledgements</h3> The authors are grateful to all respondents for completing the questionnaire. The authors also thank various patient support groups and organizations for their contribution to the dissemination of this survey. Finally, the authors wish to thank all members of the COVAD study group for their invaluable role in the data collection. <h3>Disclosure of Interests</h3> Parikshit Sen: None declared, Naveen Ravichandran: None declared, Mrudula Joshi: None declared, Sreoshy Saha: None declared, Kshitij Jagtap: None declared, Vishwesh Agarwal: None declared, Oliver Distler Speakers bureau: Boehringer Ingelheim, Inventiva, Janssen, Medscape, Prometheus, Consultant of: 4P-Pharma, Abbvie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Lupin, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi and Topadur. Patent issued "mir-29 for the treatment of systemic sclerosis" (US8247389, EP2331143), Grant/research support from: Bayer, Boehringer Ingelheim, Kymera, Mitsubishi Tanabe, Topadur, Elena Nikiphorou Speakers bureau: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Lilly, Grant/research support from: Pfizer, Lilly, Ai Lyn Tan Speakers bureau: Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Consultant of: Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Samuel Katsuyuki Shinjo: None declared, Nelly Ziade Speakers bureau: Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, Pierre Fabre, Consultant of: Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, Pierre Fabre, Tsvetelina Velikova: None declared, Marcin Milchert: None declared, Ioannis Parodis Consultant of: Amgen, AstraZeneca, Aurinia Pharmaceuticals, Elli Lilly and Company, Gilead Sciences, GlaxoSmithKline, Janssen Pharmaceuticals, Novartis, F. Hoffmann-La Roche AG, Abraham Edgar Gracia-Ramos: None declared, Lorenzo Cavagna: None declared, Masataka Kuwana: None declared, Johannes Knitza: None declared, Ashima Makol: None declared, Aarat Patel: None declared, John Pauling: None declared, Chris Wincup: None declared, Bhupen Barman: None declared, ERICK ADRIAN ZAMORA-TEHOZOL: None declared, Jorge Rojas-Serrano: None declared, Ignacio Garcia-De La Torre: None declared, Iris Jazmin Colunga-Pedraza: None declared, Javier Merayo-Chalico: None declared, Wanruchada Katchamart: None declared, Phonpen Akarawatcharangura Goo: None declared, Yi-Ming Chen: None declared, Leonardo Santos Hoff: None declared, Lina Kibbi: None declared, Hussein Halabi: None declared, Binit Vaidya: None declared, Syahrul Sazliyana Shaharir: None declared, Russka Shumnalieva: None declared, A.T.M. Tanveer Hasan: None declared, Dey Dzifa: None declared, Carlos Enrique Toro Gutierrez: None declared, Carlo Vinicio Caballero: None declared, James B. Lilleker Speakers bureau: Sanofi Genzyme, Roche, Biogen, Consultant of: Sanofi Genzyme, Roche, Biogen, Babur Salim: None declared, Tamer A Gheita: None declared, Tulika Chatterjee: None declared, Arvind Nune: None declared, Miguel A Saavedra: None declared, Jessica Day Grant/research support from: CSL Limited, Hector Chinoy Speakers bureau: UCB and Biogen, Consultant of: Novartis, Eli Lilly, Orphazyme, Astra Zeneca, Grant/research support from: Eli Lilly and UCB, Vikas Agarwal: None declared, Rohit Aggarwal Consultant of: Bristol Myers-Squibb, Pfizer, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, Abbvie, Janssen, Kyverna Alexion, Argenx, EMD-Serono, Boehringer Ingelheim, Roivant, Merck, Galapagos, Actigraph, Scipher, Horizon Therapeutics, Teva, Beigene, ANI Pharmaceuticals, Biogen, Nuvig, Capella Bioscience, and CabalettaBio, Grant/research support from: Mallinckrodt, Pfizer, Bristol Myers-Squibb, Q32, EMD-Serono, Janssen, Boehringer Ingelheim, Latika Gupta: None declared.